In reviewing the response of the Arch Collaborative’s survey on EMR usability, I frequently see comments about the physician having his or her back to the patient while documenting. Physicians feel understandably frustrated with this arrangement. They want to be able to look their patients in the eyes and talk with them instead of at them — or worse, at the computer.
These physician complaints always leave me a little bemused. Not because patient engagement isn’t important to me — I admire doctors’ desires to connect with their patients on a personal level, and I agree that this should be an important goal of each visit. However, I don’t think the EMR needs to be viewed as a barrier to patient engagement. On the contrary; I’ve seen the EMR actually increase patient engagement.
Training Unlocks Potential
To my doctors, the EMR is a tool for helping me understand my clinical status. They feel no need to hide my health information from me. Instead, my physicians have their EMR terminals positioned so that they can operate the EMR and show me its content at the same time. I enjoy this involvement in my doctors’ care-delivery process. I get to see deep data, captured from past visits, that prompts me to ask questions I might not otherwise ask. This allows my physicians to review trends with me and, when necessary, discuss actions that will improve my health.
Using the EMR as a patient engagement tool seems very feasible to me. So why don’t more physicians do it? My guess is that most of them simply don’t know how. How many provider organizations have a formal training program for instructing physicians on how to use the EMR to facilitate patient engagement? Probably not many. Teaching physicians how to optimize their use of the EMR during patient visits is crucial to unlocking the potential of both physicians and the EMR.
Clinicians’ Role in Training
As KLAS noted in a recent study (Creating the EMR Advantage), clinicians learn best from fellow clinicians. Thus, a good way to start a training program for using the EMR as a patient engagement tool during care delivery is to identify physicians who are already using the EMR effectively with their patients. These physicians can provide peer training on patient engagement techniques. This should spur interest in and adoption of helpful practices, which should, in turn, increase physicians’ satisfaction with the EMR.
As a bonus, the act of searching for clinicians who are using the EMR effectively might also identify the clinicians who aren’t. Physicians who feel uncomfortable with their EMR skills probably can’t support patient interaction while using the EMR. Finding these physicians is a great first step. At that point, clinician leaders can arrange for the struggling physicians to be given more focused and personal training to help them learn the EMR better.
Including the Patient Portal
Most EMR vendors also offer an integrated patient portal, but relatively few patients use these portals regularly. Efforts to engage patients with the EMR could also lead to progress on this problem. For one thing, providers focused on patient engagement during appointments are more likely to encourage the use of the patient portal. This is true of my physicians. They always ask during my appointments whether I have been using the patient portal, and I always answer in the affirmative.
In addition, effective use of the EMR can help even skeptical or tech-averse patients feel more eager to engage with the portal. Imagine a physician documenting diagnostic and prescription information in the EMR while discussing the information with the patient. This taste of detailed data will make the patient hungry for more. At that point, the physician could ask, “How would you like to view this same information from home?” The physician could then demonstrate how to use the portal to communicate with the clinicians, request medication refills, and view test results.
It’s Time for an Upgrade
Some providers may not want to believe it, but the EMR is here to stay. While vendors work to improve the software, provider organizations and clinician leaders have the responsibility of making some improvements of their own. It’s time to upgrade physician training with guidance on how to use the EMR as a patient engagement tool. Only then will physicians and patients alike have the tools they need to work together in the quest to health.